WA employs more overseas doctors than any other state

Regular health checkups are a service under strain as WA faces a major doctor shortage.

ABC TV

WA employs more overseas doctors than any other state and needs 950 new doctors to plug existing gaps, a report has found.

"The key findings were rather alarming, in summary we have a shortage of medical practitioners, we're not training enough and we rely really heavily on overseas trained doctors," report author and former head of WA's country health service Felicity Jefferies told the ABC.

She retired last year and is now a health consultant.

One of her first tasks was studying the state of WA's medical workforce.

"Western Australia on average has fewer medical practitioners per head of population than any other state in Australia, we also have more overseas trained doctors than any other state, Dr Jefferies said.

WA has 38 per cent of all of its medical practitioners trained overseas compared to the rest of Australia which only had 26 per cent.

Former WA Country Health Service head Felicity Jefferies

"WA has 38 per cent of all of its medical practitioners trained overseas compared to the rest of Australia which only had 26 per cent.

"We train 70 fewer medical graduates per year than the rest of Australian states."

Curtin University commissioned Dr Jefferies to conduct the report as it tries to determine if there is a need to train more medical students.

"It shows where Western Australia sits compared to the rest of Australia and I think it's important as a community we understand that."

It is a problem Sean Stevens is all too aware of.

"When I joined the practice 11 years ago, it was a big, big problem, we then became a teaching practice and that has helped ease things a bit," Dr Stevens said.

In 2004, Dr Stevens became a part owner in Mead Medical, which has two clinics in Perth's East.

He supervises doctors who are training to become GP's.

"Because we have registrars, who are doctors in training, who have been working with us, we've been lucky enough to attract those doctors to stay in the practice when they finish their training," so that has eased things significantly, Dr Stevens said.

Those graduates had to secure a position in a highly competitive government funded GP training program.

Dr Stevens says the limited number of positions is hampering the state's efforts to produce more local doctors.

"Medical graduates from medical schools is not the problem, it's actually a bottleneck in post graduate training so the issue is really getting enough doctors to go through the GP practice training program," he said.

"It's really those positions which are limited that's hampering the efforts to address the number of GPs and particularly the maldistribution of GPs."

Trebling of cohort numbers not enough

Since 2004, Western Australia has trebled the number of medical students it graduates each year to about 320.

While experts agree it has helped WA cope with a growing demand for doctor services, some say it has not been enough.

The former Director General of Health Kim Snowball says the state is still behind because it started on a low base.

"Everybody actually thought tripling the number of medical students was going to be the solution and it certainly has been a solution for a period of time, but this report shows much more needs to be done.

Kim Snowball was in the top job until March, spending almost three years at the helm.

We're reactive, so the situation we're in now, it needs a much more comprehensive plan to bring us on par with other Australian states.

Former Director General of Health Kim Snowball

He now works alongside Dr Jefferies in the consulting game.

"We've kind of looked at medical training education in segments, in parts, so we graduate students ... suddenly we don't have enough intern places," Mr Snowball said.

"We're reactive, so the situation we're in now, it needs a much more comprehensive plan to bring us on par with other Australian states."

And the Health Minister Kim Hames is not taking all the blame.

"I've been lobbying the Commonwealth for a long period of time about how they can assist us in getting more doctors," he said.

"But largely we've been chasing international doctors because we don't have enough of our own that are graduated and ready to work both as specialists in our hospitals or in the rest of the country," Dr Hames said.

Dr Jefferies says attracting enough students to commit to eleven years of study is not the problem.

"We have more people applying to do medicine that we have jobs or positions available," she said.

"Almost four or five times the number of people apply for the position."

A spokesman for the Australian Medical Association WA said the organisation was extremely concerned research that had been commissioned and paid for by Curtin University would be used to argue there was a need for more medical graduates or another medical school.

"This would not solve issues related to the distribution of General Practitioners in metropolitan or rural WA," he said.

"The WA health system is already struggling to find training places for existing medical graduates, ... and the State Government is already struggling to provide additional training places."

Complex funding bureaucracy creates problems

All parties agree there is no easy solution.

The education and training of medical students is shouldered by multiple tiers of government, universities, training centres and hospitals.

The Commonwealth provides subsidised university placements for students along with some post-graduate training while the state provides internships and resident places.

My belief is that it is a whole package, we actually have to look at the medical workforce plan and the education and training plan, we have to do it together.

Former WA Country Health Service head Felicity Jefferies

Dr Jefferies says a lack of co-ordination between all parties has caused the problem.

"My belief is that it is a whole package, we actually have to look at the medical workforce plan and the education and training plan, we have to do it together," she said.

Curtin University is planning on building a new medical school in Midland.

But while the State Government is hoping Curtin's plan will at least be part of the solution, it has already offered the university a parcel of land at a peppercorn rent, along with 22-million-dollars for construction.

But views are varied on whether that is the answer.

"A number of stakeholders said more medical students is part of the answer and Curtin may be part of that," Dr Jefferies said.

"Other stakeholders said it's much more about general practice and we need a lot more practice training places, others said it was the whole training pathways from the interns to the junior doctors."

Dr Stevens believes a third medical school is not the answer.

"There's no need for another medical school in Western Australia," she said.

"There are already many people who are graduating from Notre Dame and UWA who are unable to get internships and resident positions or positions on the GP training program."